CHILD DISRUPTIVE &/OR MOOD DISORDERS--DIAGNOSIS & COURSE

目前的项目是三个阶段调查的开始 儿童期破坏性障碍和抑郁障碍的外部效度。这个 该项目的目的是比较破坏性和破坏性/抑郁 儿童对四大类因变量的依赖：背景 (社会经济地位、育儿方式、生活环境)；个人 (转诊时的认知、学习和注意力表现)；治疗 反应(行为管理对药物的初始反应)； 和结果(16岁时的精神、认知和行为状态 年满21岁)。 在该项目的初始诊断和治疗响应阶段，192 7至11岁的男性门诊患者将在一年多的时间内接受研究 四年期。将组成六个诊断亚组：独家 过度活跃；独有攻击性；共病过度活跃和攻击性； 多动与抑郁并存；攻击性与抑郁并存； 以及过度活跃/好斗/抑郁的混合体。在基线诊断之后 评估，每个孩子将被随机分配到10周 安慰剂对照药物治疗(哌醋甲酯)或10 数周的心理治疗(以行为为导向的父母组 培训)。 计划中的多变量分析将解决不同有效性的问题 和合并症。我们将研究两种诊断系统，然后进行比较： Loney的二维模型和DSM(III、III-R和IV)系统。一个 核心的实质性问题是，这两个小组内部和之间的小组 诊断模型具有不同的流行率、背景因素或 治疗反应。一个核心的方法论目标是比较经验 和临床方法，用于组合来自量表、来源、 和设置。这些活动的最终目标是派生声音 关于统一诊断扰乱儿童的建议。

The current project is the beginning of a three-phase investigation of the external validity of childhood disruptive and depressive disorders. The aim of the project is to compare disruptive and disruptive/depressive children on four main classes of dependent variables: Background (socioeconomic status, parenting styles, living circumstances); Individual (cognitive, academic, and attentional performance at referral); Treatment Response (initial responsiveness to medication of behavioral management); and Outcome (psychiatric, cognitive, and behavioral status at 16 and again at 21 years of age). In this initial Diagnostic and Treatment Response phase of the project, 192 male out-patients between 7 and 11 years of age will be studied over a four-year period. Six diagnostic subgroups will be formed: Exclusively Hyperactive; Exclusively Aggressive; Comorbid Hyperactive and Aggressive; Comorbid Hyperactive and Depressive; Comorbid Aggressive and Depressive; and Mixed Hyperactive/Aggressive/Depressive. After a baseline diagnostic assessment, each child will be randomly assigned to receive either 10 weeks of a placebo-controlled pharmacological treatment (methylphenidate) or 10 weeks of a psychological treatment (behaviorally oriented parent group training). Planned multivariate analyses will address questions of divergent validity and comorbidity. Two diagnostic systems will be studied and then compared: Loney's Two-Dimensional model and the DSM (III, III-R, and IV) system. A central substantive question is whether subgroups within and across the two diagnostic models have different prevalence, background factors, or treatment response. A central methodological aim is to compare empirical and clinical methods for combining diagnostic data from scales, sources, and settings. A final goal of these activities is to derive sound proposals for unifying the diagnosis of disruptive children.